In modern surgery, one of the most important instruments available to medical personnel is the powered surgical tool. Typically, this tool comprises some type of handpiece in which a motor is housed. Secured to the handpiece is an accessory designed for application to a surgical site on a patient in order to accomplish a specific medical task. Some powered surgical tools are provided with drills or burs for cutting bores into hard tissue or for selectively removing the hard tissue. Still other powered surgical tools are provided with saw blades as cutting accessories. These tools are used for separating large sections of hard and/or soft tissue. The ability to use powered surgical tools on a patient has lessened the physical strain of physicians and other medical personnel when performing procedures on a patient. Moreover, most surgical procedures can be performed more quickly, and more accurately, with powered surgical tools than with the manual equivalents that preceded them.
The Applicant's Assignee's U.S. Pat. No. 5,888,200, entitled, MULTI-PURPOSE SURGICAL TOOL SYSTEM, issued Mar. 30, 1999, incorporated herein by reference, discloses a surgical tool system designed for a number of different applications. This tool system includes a handpiece in which a motor is housed. The handpiece also includes a first coupling assembly for selectively coupling the shaft of an accessory to the motor shaft. This handpiece also includes a second coupling assembly. The second coupling assembly is used to selectively secure an attachment to the front end of the handpiece. This attachment may include its own drive shaft and accessory coupling assembly. These attachments are elongated attachments, angled attachments and/or able to actuate saw blades. Thus, an advantage of providing this type of tool system is that a single handpiece can be used to drive a large number of different cutting accessories and facilitate the positioning of the accessories at the surgical site in a manner that is either required or desired for a particular surgical procedure.
Popular cutting accessories that are used with this type of surgical tool system include drills and burs. Each of these cutting accessories typically has a head that forms the actual tissue removal member of the accessory. A shaft extends rearwardly from the head. The shaft is the component of the cutting accessory against which the coupling assembly locks.
There is a limitation associated with the above-described system. The coupling assembly of this system is designed so that a cutting accessory can only be secured to it in a single, fixed location relative to the handpiece. A disadvantage of this arrangement is that surgeons frequently find it useful to have some degree of flexibility in positioning the head of the cutting accessory relative to the handpiece. To date, to offer this flexibility, it is necessary to provide a set of cutting accessories that have identical cutting heads. The difference between the accessories is the length of their complementary shafts. When a surgeon wants the head of the accessory to be positioned relatively close to the handpiece, he/she installs in the handpiece a cutting accessory with a shaft that is relatively short in length. If the surgeon wants the head of the accessory to be spaced a distance from the handpiece, he/she installs in the handpiece a cutting accessory that has a relatively long shaft.
Moreover, during a surgical procedure, a surgeon may want to use different tools to access different locations at the surgical site. Alternatively, surgeons have individual preferences regarding how they want to view a surgical site and/or handle their surgical tools. In order to accommodate these variations, surgical tool systems are provided with members that vary in only the geometry and/or dimensions of the components employed to transfer the power developed by the handpiece motor to the associated cutting accessory. For example, the tool system described in the above-referenced U.S. Pat. No. 5,888,200 has different length attachments and attachments that have distal end sections that are straight and angled from the associated handpiece housing. If surgeon has to access a surgical site located close to the skin of the patient he/she has available a medium length attachment. Alternatively, if the surgeon has to access a surgical site deep within the patient, the surgeon has available a long attachment. This attachment, in comparison to the medium length attachment, holds the head of the cutting accessory a relatively long distance away from handpiece. Angled attachments are also available. These attachments are used to hold the cutting accessory at an angle that is offset to the longitudinal axis of the handpiece. Angled attachments are used to position the cutting accessory at surgical sites that are difficult to reach and/or to provide a surgeon with an alternative field of view of the surgical site.
Clearly, having these different attachments available is beneficial to the surgeon. However, the coupling assemblies internal to these attachments are often located different longitudinal distances from their head ends, theirs distal ends, the ends from which the shaft of the accessory emerges. In order to use these attachments, it is necessary to provide cutting accessories with the same head but that have different length shafts. Accessories with short length shafts are fitted into attachments in which the coupling assemblies are positioned relatively short distances from their distal end openings. Accessories with long length shafts are fitted into attachments in which the coupling assemblies are positioned longer distances from their distal end openings. This is another reason why it is sometimes necessary to have a number of different cutting accessories available for use in a single surgical procedure that vary only in their shaft length.
Another limitation associated with cutting accessories such as drills and burs is related to the fact that sometimes a number of different accessories are packaged as a set. These accessories are so packaged together because a surgeon, during a procedure, may want to view the complete set of accessories he/she has available for use. Alternatively, prior to the beginning of a surgical procedure, a number of individual accessories are each unpackaged and arranged as a set for the surgeon. Again, this is to allow the surgeon to both view and have easy access to a number of different accessories.
However, often, during a procedure, the surgeon does not use all of the cutting accessories that have been unwrapped from their sterile packaging. The accessories that are used are typically discarded. This is because the cutting heads of these accessories are at least partially worn. However, after the procedure, there may be one or more exposed cutting accessories that were not used. These accessories can be used in a new procedure, if prior to reuse they are sterilized to remove any contaminates they may have picked up as a result of their exposure to the environment. In a procedure used to sterilize these accessories they are heated to a temperature of approximately 132 C, and subjected to saturated water vapor at a pressure of 2.1 bars. These accessories are formed of tool steel because cutting surfaces formed from this material tends to wear at a slower rate cutting surfaces formed from stainless steel. Also, tool steel is less expensive than an alternative material, carbide steel. However, during the above-described sterilization process, the tool steel tends to discolor. This discoloration is disconcerting to medical personnel. Consequently, medical personnel are reluctant to use these unused autoclave-sterilized accessories even though their quality and the degree of sterilization is the same as accessories that have just been removed from the manufacturer's packaging. Thus, there is tendency to discard these unused accessories even though, with proper sterilization, they can be available for use in a later procedure. The discarding of these cutting accessories, even though they have not even been used, is a waste of resources.
The Applicant's Assignee's U.S. Pat. No. 6,562,055 provides a surgical tool system to which cutting accessories are selectively attached. The surgical tool system in the '055 patent includes a specially designed cutting accessory with retention features. As shown in FIGS. 40 and 41 of the '055 patent, the retention features are comprised of cut-outs in the shaft of the cutting accessory. The cutouts work with a locking mechanism which allows the longitudinal position of the accessory relative to a hand tool to be adjusted. The relative position may be adjusted between positions defined by the cutouts and the distance between positions is equal to the longitudinal distance between the cutouts. Thus, in the ″055 system, the relative position may only be adjusted in increments equal to this distance. Practically it has been found that the retention features need to be spaced apart a minimum of 2.4 mm. If the retention features are spaced apart smaller distances, the features would therefore be smaller. The complementary coupling features of the handpiece coupling assembly might then not be able to grasp the retention features over a large enough surface area to ensure the transfer of torque from the handpiece coupling features to the accessory shaft.